11 beta HSD-1 gene polymorphism in patients with type 2 diabetes, metabolic syndrome and PCOS- Effect of carbenoxolone (Licorice) on anthropometric and metabolic parameters of patients with this polymorphism

Diabetes has become one of the major causes of morbidity with more than 285 millions worldwide having this condition. The prediabetic conditions like metabolic syndrome (metS) and polycystic ovary syndrome (PCOS) are also increasing in prevalance. Type 2 diabetes, metS and PCOS show charcteristic insulin resistance in subjects, which is why they are closely related. Subjects with these conditions are characterised by cushingoid features. 11 beta HSD enzyme which has a major role in glucocorticoid (GC) metabolism may alter GC action due to the polymorphism in the gene encoding them. Recently much attention has been given to the pharmacological manipulation of cortisol metabolism as therapeutic strategy. 11 B HSD-1 inhibitor like licorice is known to decrease local GC generation, decrease blood glucose, lipids and improve insulin sensitivity. Licorice is been used in medicine for more than 4000 years. It is used as anti-ulcer,anti-inflammatory agent, demulcent, expectorant, laxative, sweetener, bronchodilator,diuretic,anti-pyretic,rejuvenator, skin fairness,etc. Our current study is to explore the role of 11 B HSD-1 gene polymorphisms in subjects with type 2 diabetes, metS and PCOS and to study the pharmacological use of licorice (carbenoxolone) in treatment of these abnormalities by their interference in cortisol metabolism.